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[不同原发病导致儿童长期机械通气的临床特征]

[Clinical characteristics of children on prolonged mechanical ventilation due to different primary diseases].

作者信息

Zhu Jun-Zhen, Li Zheng, Cui Li-Dan, Mei Shi-Yue, Li Xiao-Lei, Fang Bing, Qian Su-Yun, Cheng Yi-Bing

机构信息

Department of Pediatric Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 May 15;26(5):481-485. doi: 10.7499/j.issn.1008-8830.2311035.

Abstract

OBJECTIVES

To investigate the differences in clinical characteristics among children on prolonged mechanical ventilation (PMV) due to different primary diseases.

METHODS

A retrospective analysis was performed on the clinical data of 59 pediatric patients requiring PMV from July 2017 to September 2022. According to the primary disease, they were divided into respiratory disease (RD) group, central nervous system (CNS) group, neuromuscular disease (NMD) group, and other disease group. The four groups were compared in terms of general information, treatment, and outcome.

RESULTS

There were significant differences among the four groups in age, body weight, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, Pediatric Risk of Mortality III (PRISM Ⅲ) score, analgesic and sedative treatment, nutrition supply, rehabilitation treatment, tracheotomy, successful ventilator weaning, and outcomes (<0.05). Compared with the RD group, the CNS group and the other disease group had a significantly higher age and a significantly higher proportion of children receiving rehabilitation treatment, and the CNS group had a significantly higher proportion of children receiving tracheotomy (<0.008). Compared with the other disease group, the CNS group and the NMD group had significantly lower PELOD-2 and PRISM III scores, and the CNS group had a significantly higher proportion of children with successful ventilator weaning and a significantly higher proportion of children who were improved and discharged (<0.008).

CONCLUSIONS

There are differences in clinical characteristics among children receiving PMV due to different etiologies. Most children in the RD group have a younger age, and children in the CNS group have a relatively good prognosis.

摘要

目的

探讨因不同原发疾病接受长时间机械通气(PMV)的儿童临床特征的差异。

方法

对2017年7月至2022年9月期间59例需要PMV的儿科患者的临床资料进行回顾性分析。根据原发疾病,将他们分为呼吸系统疾病(RD)组、中枢神经系统(CNS)组、神经肌肉疾病(NMD)组和其他疾病组。比较四组的一般信息、治疗情况及结局。

结果

四组在年龄、体重、小儿逻辑器官功能障碍-2(PELOD-2)评分、小儿死亡风险Ⅲ(PRISMⅢ)评分、镇痛和镇静治疗、营养供给、康复治疗、气管切开、成功撤机及结局方面存在显著差异(<0.05)。与RD组相比,CNS组和其他疾病组年龄显著更大,接受康复治疗的儿童比例显著更高,且CNS组接受气管切开的儿童比例显著更高(<0.008)。与其他疾病组相比,CNS组和NMD组的PELOD-2和PRISMⅢ评分显著更低,CNS组成功撤机的儿童比例显著更高,病情改善并出院的儿童比例显著更高(<0.008)。

结论

因不同病因接受PMV的儿童临床特征存在差异。RD组大多数儿童年龄较小,CNS组儿童预后相对较好。

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